دورية أكاديمية
National Institute on Drug Abuse Clinical Trials Network Meeting Report: Managing Patients Exposed to Xylazine-Adulterated Opioids in Emergency, Hospital and Addiction Care Settings.
| العنوان: | National Institute on Drug Abuse Clinical Trials Network Meeting Report: Managing Patients Exposed to Xylazine-Adulterated Opioids in Emergency, Hospital and Addiction Care Settings. |
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| المؤلفون: | Perrone J; Department of Emergency Medicine, Penn Center for Addiction Medicine and Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Electronic address: jeanmarie.perrone@pennmedicine.upenn.edu., Haroz R; Center for Healing, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ., D'Orazio J; Center for Healing, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ., Gianotti G; University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA., Love J; Icahn School of Medicine at Mount Sinai, New York, NY., Salzman M; Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ., Lowenstein M; Division of General Internal Medicine, Penn Center for Addiction Medicine and Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Thakrar A; Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Klipp S; Courage Medicine, Unity Recovery, Philadelphia, PA., Rae L; Lewis Katz School of Medicine, Temple University, Philadelphia, PA., Reed MK; Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA., Sisco E; National Institute of Standards and Technology, Gaithersburg, MD., Wightman R; Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI., Nelson LS; Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ. |
| المصدر: | Annals of emergency medicine [Ann Emerg Med] 2024 Jul; Vol. 84 (1), pp. 20-28. Date of Electronic Publication: 2024 Mar 16. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mosby Country of Publication: United States NLM ID: 8002646 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6760 (Electronic) Linking ISSN: 01960644 NLM ISO Abbreviation: Ann Emerg Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: St. Louis, MO : Mosby Original Publication: [Lansing, Mich., American College of Emergency Physicians] |
| مواضيع طبية MeSH: | Xylazine* , Analgesics, Opioid*/adverse effects, Humans ; United States ; Fentanyl/adverse effects ; Opioid-Related Disorders/drug therapy ; National Institute on Drug Abuse (U.S.) ; Naloxone/therapeutic use ; Narcotic Antagonists/therapeutic use ; Drug Overdose/drug therapy ; Opiate Overdose ; Hypnotics and Sedatives/adverse effects ; Emergency Service, Hospital |
| مستخلص: | Used as a veterinary sedative and not approved for human use, xylazine has been increasingly linked with opioid overdose deaths in the United States. A growing number of people have been exposed to xylazine in the illicit opioid supply (especially fentanyl) or in other drugs, particularly in some areas of the Northeast. Xylazine is an α-2 adrenergic agonist that decreases sympathetic nervous system activity. When combined with fentanyl or heroin, it is purported to extend the duration of the opioid's sedative effect and to cause dependence and an associated withdrawal syndrome; however, data to support these concerns are limited. Despite the escalating frequency of detection of xylazine in people with nonfatal and fatal opioid overdose, direct links to these outcomes have not been identified. Because the strongest causal link is to fentanyl coexposure, ventilatory support and naloxone remain the cornerstones of overdose management. Xylazine is also associated with severe tissue injury, including skin ulcers and tissue loss, but little is known about the underlying mechanisms. Nonetheless, strategies for prevention and treatment are emerging. The significance and clinical effects of xylazine as an adulterant is focused on 4 domains that merit further evaluation: fentanyl-xylazine overdose, xylazine dependence and withdrawal, xylazine-associated dermal manifestations, and xylazine surveillance and detection in clinical and nonclinical settings. This report reflects the Proceedings of the National Institute on Drug Abuse Center for the Clinical Trials Network convening of clinical and scientific experts, federal staff, and other stakeholders to describe emerging best practices for treating people exposed to xylazine-adulterated opioids. Participants identified scientific gaps and opportunities for research to inform clinical practice in emergency departments, hospitals, and addiction medicine settings. (Copyright © 2024 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.) |
| المشرفين على المادة: | 2KFG9TP5V8 (Xylazine) 0 (Analgesics, Opioid) UF599785JZ (Fentanyl) 36B82AMQ7N (Naloxone) 0 (Narcotic Antagonists) 0 (Hypnotics and Sedatives) |
| تواريخ الأحداث: | Date Created: 20240317 Date Completed: 20240621 Latest Revision: 20240621 |
| رمز التحديث: | 20240622 |
| DOI: | 10.1016/j.annemergmed.2024.01.041 |
| PMID: | 38493376 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1097-6760 |
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| DOI: | 10.1016/j.annemergmed.2024.01.041 |